Affordable Health Care (Warning)

[jvarnell]

Here's a question: Should we repeal laws that require people to have electricity and running water to be permitted to live in a house? How about just repealing the requirement for electricity? After all, aren't those just newfangled luxuries when viewed through the perspective of human history as a whole? Is there one standard, forever and eternal, for what is deemed and enforced as "necessary" by a society, or is it possible that the standard can validly change? If you believe there is only one eternal standard, then you had better start lobbying to repeal all requirements for residential electricity. PS: Yes, the government does subsidize private electricity use by the low-income...

I am one of those rule makers in the electric industry which is mostly privet companies and NO the government doesn't subsidize any electric at all. It is all done through privet donations. I also work with my local food pantry which will pay bill when needed. In Texas TXU and Reliant energy are the only companys that give that pantry money for bills. The only law to have electricity is some local occupancy law in cities and municipalities. I do this work in many electric ISO/RTO of the US and Canada. ERCOT, SPP, MISO, PJM SERC,WECC.....

You can see me in the TAC meeting videos in the link below and the only reason I am putting this link out there is in the past what I have said has been impuned with out evidence. http://www.texasadmin.com/ercotac.shtml

 

[jvarnell]

To understand why Obomacare will not lower any cost and can not you will have to think about the diferance between health care and health insurance. No one is or has ever been denied health care. The problem is who and how it is paid for. When you put the government or anyone else in the middle you will always increase the cost for each level added. the insurance companies already are there and Obomacare adds the IRS and buracrats in there. Insurance is a socialassion of dollars at a time point so there is not a big spike in how someone spends. This could be fixed with health savings accounts.

 

[dfreybur]

T This could be fixed with health savings accounts.

They were just beginning to drive total costs down when Obamacare was passed. They were not given the time needed for the process to run to stable lower prices.

With HSAs folks saw the price of every medical decision and the initial prices came out of their pocket, pretax if they signed up for that. Knowing the price drove decision making to take price into account. But it it hit the fan there was still coverage for bad medical years when you exceeded your out of pocket maximum.

With Obamacare folks are going to act like medical care is free and not associated with the price of the insurance, as has been happening gradually over time anyways. Acting like it's free drives the actual costs up. it's a variation on the tragedy of the commons.

 

[Txmason]

Any Bros. in the insurance business that I might be able to talk to as I need new insurance after having the Texas High Risk Pool which is going away. I would appreciate any help that can be offered.

Best,
Jerry


"Without exertion there can be no progress." Bear Grylls

 

[dfreybur]

Because the quote on healthcare.gov is even more expensive and doesn't include dental.

If you want more accurate information be prepared for a shock. Go to the companies listed for each plan offered and look up the public price listing. If you are like us it will be at least twice what we are paying now. As I expected. My wife was furious and all I could say was I had predicted that well over a year ago.

Apparently all of the Obamacare plans include dental and vision. The wording is something like children's dental. When I tried to read about that I didn't understand what it meant. For generations we have been underwriting elementary school through high school primary and secondary education with taxes so it's likely something like that.

 

[BryanMaloney]

I called Aetna directly and asked them why my premiums are going up and without hesitation I was told "due to the implementation of the Affordable Care Act."

You could have called them ten years ago and asked the same question, and the answer would have been "Because f--- you." Insurance premiums go up, and nothing ever stops this. This time around, though, there is someone convenient to blame. Part of the problem is that, for decades, insurance companies reaped the benefits of a sweet, sweet, sweet Federal government deal hatched by Roosevelt the Second. During WWII, a wage freeze was implemented. Employers screamed blue bloody murder--they couldn't get good people. Roosevelt exempted employer contributions to health insurance from the freeze and from other aspects of wages, such as taxation. That meant it the government essentially encouraged employers, big-time, to give money to insurance companies. A few decades later, here we are, and it's time to pay the piper. Uncle Sugar hands out nothing for free. Eventually, like any Mafia Don, he comes knocking to collect payment for his little "favor".

What makes matters worse is that the insurance companies were quite profligate. Instead of driving hard bargains with medical providers, most plans just ponied up. The 500-lb gorillas of Medicare and Medicaid would have made it hard for commercial insurance to have played hard-ball, though.

 

[BryanMaloney]

I am one of those rule makers in the electric industry which is mostly privet companies and NO the government doesn't subsidize any electric at all. It is all done through privet donations. I also work with my local food pantry which will pay bill when needed. In Texas TXU and Reliant energy are the only companys that give that pantry money for bills. The only law to have electricity is some local occupancy law in cities and municipalities. I do this work in many electric ISO/RTO of the US and Canada. ERCOT, SPP, MISO, PJM SERC,WECC.....

Really, so the TVA wasn't a government project? Funny, I did not know that. You'd better contact the TVA and tell them to stop lying to everyone about being affiliated with the government. And you, yourself, admit to laws requiring residential electricity--even if they are "local occupancy laws". They still have the force of law.

 

[sani]

Hello my bro

Sent from my SM-N900P using My Freemasonry HD mobile app

 

[JohnnyFlotsam]

Have these things been attempted (especially wealth re-distribution)?

If so, how did they turn out? What were these Great Societies like?

Well, yes, as a matter of fact, they have been attempted, and they were rather successful. Let's start with the U.S.

I believe that we can agree that the period of time that spans the end of WWII to the mid-70's as the summit of this country's economy. The middle class grew the most during that time. That's a redistribution of wealth, BTW. Now let's have a look at the top and bottom bracket tax rates. http://www.ntu.org/tax-basics/history-of-federal-individual-1.html
ZOMG! Taxes on the wealthiest were as high as 92%! And yet..., the economy continued to grow.
Want to see some real wealth redistribution? See - http://www.advisorperspectives.com/...ncome.html?household-incomes-mean-nominal.gif
Note the dramatic divergence of of those top two lines that began in the late '70's and really took off in the early '90's.

While the correlation between median income and a healthy economy can not be ignored, the glaring inconsistency is in where the tax revenue is coming from.

OK. Enough about the good old days. What's happening in the world today? The UN's "Human Development Index" (HDI) is as good a yardstick as there is when comparing "standard of living" internationally. It measures things like income, education, and life expectancy. The IHDI (inequality-adusted HDI) is the measure of actual development (versus potential). http://en.wikipedia.org/wiki/List_of_countries_by_inequality-adjusted_HDI
While we have recovered some since the huge drop in the 2011 report, we still suck compared to all those "socialist" European countries. They must be doing something right.

 

[JohnnyFlotsam]

No one is or has ever been denied health care.

Sigh...
While this is a common misconception, reinforced regularly by the conservative echo chamber, it is patently false. Yes, your medical emergency will be treated if you show up at the emergency room, regardless of your ability to pay, but you will be expected to pay what you can. What you can't pay for is covered by the rest of us who do have health insurance. That care is not "free", by any measure. Moreover, it is just about the most expensive care available. Using ER's as the "safety net" for health care is nothing short of insane from the standpoint of cost effectiveness, and not just because of the price tag for what you can get in that scenario...

Try going to the ER for any preventative medicine-type visit. You will be shown the door. So all that money that might have been saved if you had access to cost-effective health care is lost. Again, those of us that do have health insurance pick up that tab.

The problem is who and how it is paid for.

So far, you are quite correct. The price tag on any given medical test or treatment is driven by what the insurer's will pay. Since the insurance industry makes it's money off of what they do with our money while they're holding onto it, it is always in their interest to have that amount be as high as possible. Of course it is also important for them to make it as difficult as possible for the health care vendors to receive any of that money, and their strategies for this have been raised to a fine art.

When you put the government or anyone else in the middle you will always increase the cost for each level added.

Well, no. You don't.
http://healthaffairs.org/blog/2011/09/20/medicare-is-more-efficient-than-private-insurance/

Seems to me that something like "Medicare for everyone" would have been a much more efficient system than the mess that is Obamacare.

Health care is not free, but it does not have to cost what it does in the U.S. right now. Again, by any credible measure, we (the U.S.A.) just plain suck at getting value for our dollars spent on healthcare.

 

[dfreybur]

Well, yes, as a matter of fact, they have been attempted, and they were rather successful. Let's start with the U.S.

I believe that we can agree that the period of time that spans the end of WWII to the mid-70's as the summit of this country's economy. The middle class grew the most during that time. That's a redistribution of wealth, BTW. Now let's have a look at the top and bottom bracket tax rates. http://www.ntu.org/tax-basics/history-of-federal-individual-1.html
ZOMG! Taxes on the wealthiest were as high as 92%! And yet..., the economy continued to grow.
Want to see some real wealth redistribution? See - http://www.advisorperspectives.com/...ncome.html?household-incomes-mean-nominal.gif
Note the dramatic divergence of of those top two lines that began in the late '70's and really took off in the early '90's.

While the correlation between median income and a healthy economy can not be ignored, the glaring inconsistency is in where the tax revenue is coming from.

OK. Enough about the good old days. What's happening in the world today? The UN's "Human Development Index" (HDI) is as good a yardstick as there is when comparing "standard of living" internationally. It measures things like income, education, and life expectancy. The IHDI (inequality-adusted HDI) is the measure of actual development (versus potential). http://en.wikipedia.org/wiki/List_of_countries_by_inequality-adjusted_HDI
While we have recovered some since the huge drop in the 2011 report, we still suck compared to all those "socialist" European countries. They must be doing something right.

Trying to compare those charts after adjusting for inflation makes a very large difference. Since around 1980 there has been roughly a factor of 10 increase in prices. That means in 1982 when there was a 50% income tax on income over $102K that's the equivalent now on $1M. The accelerating graph takes on a similarly different meaning once adjusted for inflation.

Incidentally the chart to show the problem of diverging wealth is the net worth one not the income one. And more particularly the inflation adjusted net worth. Diverging wealth is a problem but I don't see how it correlates to health care.

As to the UN chart sure enough it shows the US and Canada in the second best shading color. Compared to most of the world we thus have incremental improvements as our goal.

The standard reaction to increasing tax rates applies - Given the job the government currently does with the money why should anyone favor giving them more? This applies especially to medicine. Currently the US spends far more than other countries but does not have the best results. Throwing additional money at the problem is thus not the answer, nor is giving the government more of the money.

 

[jvarnell]

Sigh...
While this is a common misconception, reinforced regularly by the conservative echo chamber, it is patently false. Yes, your medical emergency will be treated if you show up at the emergency room, regardless of your ability to pay, but you will be expected to pay what you can. What you can't pay for is covered by the rest of us who do have health insurance. That care is not "free", by any measure. Moreover, it is just about the most expensive care available. Using ER's as the "safety net" for health care is nothing short of insane from the standpoint of cost effectiveness, and not just because of the price tag for what you can get in that scenario...

Try going to the ER for any preventative medicine-type visit. You will be shown the door. So all that money that might have been saved if you had access to cost-effective health care is lost. Again, those of us that do have health insurance pick up that tab.


So far, you are quite correct. The price tag on any given medical test or treatment is driven by what the insurer's will pay. Since the insurance industry makes it's money off of what they do with our money while they're holding onto it, it is always in their interest to have that amount be as high as possible. Of course it is also important for them to make it as difficult as possible for the health care vendors to receive any of that money, and their strategies for this have been raised to a fine art.


Well, no. You don't.
http://healthaffairs.org/blog/2011/09/20/medicare-is-more-efficient-than-private-insurance/

Seems to me that something like "Medicare for everyone" would have been a much more efficient system than the mess that is Obamacare.

Health care is not free, but it does not have to cost what it does in the U.S. right now. Again, by any credible measure, we (the U.S.A.) just plain suck at getting value for our dollars spent on healthcare.

I also want to "Sigh" because you think it is a misconception. It is very true it is just how much healthcare you receive. The responsibility on your self and not the general public for the equality of outcomes in healthcare. You have the responsibility for your own healthcare and it is not a right. Just like as a Mason you have the responsibility to help the poor and penny less bro. ... How can the Government be the one to order you too. The outcome of healthcare is a personal thing.

 

[BryanMaloney]

Trying to compare those charts after adjusting for inflation makes a very large difference.

Funny you should say "adjusting for inflation". My eldest son babbled some silly nonsense about historical tax rates lately, so I decided to see what the reality was. I pulled down information from the IRS on annual taxation for several years (1950-2010, in 5-year increments), specifically of number of returns filed by income and total income taxes collected by income. I adjusted for inflation using the "price of a consumer bundle" (which reflects a "historically steady lifestyle" more accurately than does the consumer price index). A little math, and we get the following:


The income is a log10 scale. You will note that, while the highest top taxation was in 1950, by 1955, the actual inflation-adjusted true taxation on the basis of income taxes collected had visibly dropped and remained in a very tight cluster from 1955-1985. Then another cluster appeared in 1990-2010. The higher-tax cluster was during the "summit" of the US economy AND the "nadir" of the recession of the 1970s. Indeed, the taxation of the 1970s was indistinguishable from the taxation of the best of the boom years. The second cluster has a much lower "top" effective tax rate, however it crosses both the alleged economic "golden age" under Clinton and the alleged "great recession" that followed under Bush and Obama.

What I take home from this is that tax bracket structures could very well be prosperity-neutral! We neither taxed our way into prosperity nor did we tax away prosperity. Instead, our economy after WWII has done what it has done regardless of how we diddle with our income tax structure. This is, of course, heresy to both sides of the question.

It also only reflects one element--the effective tax "rate" as a percentage of income vs. said income level.

 

[BryanMaloney]

Well, yes, as a matter of fact, they have been attempted, and they were rather successful. Let's start with the U.S.

I believe that we can agree that the period of time that spans the end of WWII to the mid-70's as the summit of this country's economy. The middle class grew the most during that time. That's a redistribution of wealth, BTW. Now let's have a look at the top and bottom bracket tax rates. http://www.ntu.org/tax-basics/history-of-federal-individual-1.html
ZOMG! Taxes on the wealthiest were as high as 92%.

Are you aware of just how wacky the US tax code was at that time? It was possible to structure things in such a way that, in 1969, at least 155 people were in the "high income" category of the IRS and yet paid not a penny of income tax--these were the people allegedly in that 92% bracket. They did not break the law of that time, even though they were in that bracket. This is why Alternative Minimum Tax was passed. It would have been smarter to reform the whole system, but Congress can't think that far ahead. Blindly citing historical tax brackets proves nothing.